Breast-feeding, aeroallergen sensitization, and environmental exposures during infancy are determinants of childhood allergic rhinitis
Open accessAbstract
Background Infant predictors of early childhood allergic rhinitis (AR) are poorly understood.Objective We sought to identify environmental exposures and host factors during infancy that predict AR at age 3 years.Methods High-risk children from greater Cincinnati were followed annually from ages 1 to 3 years. AR was defined as sneezing, runny, or blocked nose in the prior 12 months and a positive skin prick test (SPT) response to 1 or more aeroallergens. Environmental and standardized medical questionnaires determined exposures and clinical outcomes. Primary activity area dust samples were analyzed for house dust endotoxin (HDE) and (1-3)-beta-D-glucan. Fine particulate matter sampled at 27 monitoring stations was used to estimate personal elemental carbon attributable to traffic exposure by using a land-use regression model.Results Of 361 children in this analysis, 116 had AR, and 245 were nonatopic and nonsymptomatic. Prolonged breast-feeding in African American children (adjusted odds ratio [aOR], 0.8; 95% CI, 0.6-0.9) and multiple children in the home during infancy was protective against AR (aOR, 0.4; 95% CI, 0.2-0.8). Food SPT response positivity and tree SPT response positivity in infancy increased the risk of AR at age 3 years (aOR of 4.4 [95% CI, 2.1-9.2] and aOR of 6.8 [95% CI, 2.5-18.7], respectively). HDE exposure was associated with AR; the effect was dependent on exposure level. Elemental carbon attributable to traffic and environmental tobacco smoke exposure showed no effect on AR.Conclusion Prolonged breast-feeding in African American subjects and multiple children in the home during infancy reduced the risk of AR at age 3 years. SPT response positivity to food and tree allergens enhanced risk. The HDE effect on AR was related to exposure.
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Five prospective cohort studies examined the effect of tobacco on the development of allergic rhinitis, and all failed to find a correlation between active or passive tobacco smoke and the development of allergic rhinitis.
“Five prospective cohort studies examined the effect of tobacco on the development of AR, all of which failed to find a correlation between active or passive tobacco smoke and the development of AR.596-600”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [599]
The Methods (Predictor Variables; page unavailable) show that this prospective birth cohort assessed household environmental tobacco smoke, and the Results (Univariate Evaluation; page unavailable) do not list it among factors significantly associated with allergic rhinitis. This supports the claim for passive smoke in one cohort, but the paper does not establish the stated result for five cohorts or for active smoking. (LLM, conf=0.78)
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- Authors
- Codispoti, C. D., Levin, L., LeMasters, G. K., Ryan, P., Reponen, T., Villareal, M., Burkle, J., Stanforth, S., Lockey, J. E., Khurana Hershey, G. K., & Bernstein, D. I.
- Affiliations
- University of Cincinnati (US)
- Corresponding author
- Bernstein, David I.
- Venue
- Journal of Allergy and Clinical Immunology
- Publisher
- Elsevier BV
- Published
- 2010-05
- Volume
- 125
- Issue
- 5
- Pages
- 1054-1060.e1
- ISSN
- 0091-6749 (ISSN-L)
- PMC
- PMC4910509
- OpenAlex
- W2118561873
- Cited by
- 70
- References
- 33
- Citations by year
- 2024: 4 · 2023: 4 · 2022: 7 · 2021: 1 · 2020: 2 · 2019: 7 · 2018: 4 · 2017: 3 · 2016: 4 · 2015: 10 · 2014: 6 · 2013: 5 · 2012: 4
- FWCI
- 4.10
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Allergy and Clinical Immunology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5t32ai060515-15)
- National Institute of Allergy and Infectious Diseases (T32 AI60515, T32 AI-060515)
- National Institute of Environmental Health Sciences (ES10957, ES 11170, R01ES011170, T32ES010957)
- Topics
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Keywords
- allergic rhinitis, breastfeeding, aeroallergen sensitization, beta-D-glucan, food allergens, tree pollen allergens, traffic-related particulate matter, environmental tobacco smoke, African American children, skin prick test
- MeSH terms
- Air Pollutants, Allergens, Breast Feeding, Child, Preschool, Dust, Environmental Exposure, Female, Food, Housing, Humans, Hypersensitivity, Immediate, Male, Rhinitis, Risk Factors, Skin Tests, Trees, Air Pollution, Indoor, Inhalation Exposure
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